Nurse I

Job Description:

Nurse I: Reviews required paperwork and documents to approve or deny Community Attendant Services (CAS) and Day Activity/Health Services (DAHS). Conducts reviews and authorizes CAS services annually.
Participates in Interdisciplinary Team meetings with Health and Human Services Commission (HHSC) Community Care Services Eligibility (CCSE) case workers to resolve issues for HHS clients when needed, and to determine if services are appropriate based on program criteria.  Maintains confidentiality of all incoming and outgoing information. Understands and adheres to all HHSC and CCSE policies and procedures. Provides outstanding customer service in person, over the telephone and via e-mail. Maintains a positive and productive attitude while working in a fast-paced, high-volume   environment.  Functions as an advocate to the participant and acts as a liaison to other providers of services. May participate in HHSC fair hearings process related to the delivery of services to participants.
 

Essential Job Functions:

Attends work on a regular and predictable schedule in accordance with Agency leave policy and performs other duties as assigned. Be familiar with and follow all HHS policies and procedures relating to job performance and work rules. Reviews required paperwork and documents for accuracy and completeness to approve or deny CAS and DAHS.  Ensures information and documentation provided to CCSE staff and contracted agencies are accurate, appropriate and presented in a professional manner. Documents information manually on patient records and data enters patient information into multiple automated systems.  Reviews, completes and finalizes authorization of services in an automated system, timely and accurately. Verifies client information and performs data entry into automated systems that includes Service Authorization System Online (SASO) and multiple SharePoint sites.  Completes special assignments and reports, as assigned.  
 

Registrations, Licensure Requirements or Certifications:

Must have a valid Texas license as a Registered Nurse or licensed in a state that recognizes reciprocity through the Nurse License Compact Act.

Knowledge Skills Abilities:

Knowledge of professional nursing techniques, procedures and standards. Knowledge of CCSE program services policies and service delivery processes, preferred.  Knowledge of International Statistical Classification of Diseases, Tenth Revision (ICD10) medical diagnoses and corresponding ICD10 coding. Knowledge of medical issues related to people with disabilities/geriatric and special needs. Proficient with Microsoft Outlook and other Microsoft Office products. Experience in functioning as an advocate and as a resource for contracted service providers and co-workers. Skill in organizing workloads; skill in setting priorities and being able to effectively handle multiple responsibilities.
 

Initial Screening Criteria:

1. Submitted application must be complete.
2. Submitted application indicates applicant is currently licensed as a Registered Nurse (RN).
3. Submitted application indicates applicant has a minimum of two years professional working experience as an RN.